Depression Primary Driver of Lost Productivity in Patients with CRS

Patients with chronic rhinosinusitis (CRS) who are depressed are more likely to miss days of work or school than those without depression symptoms, according to the results of a new study published in Annals of Allergy, Asthma and Immunology. The researchers identified depression symptoms as the primary drivers of lost days of productivity in this patient population.

“We found that of all symptoms related to CRS—sinus, nasal, or otherwise—the severity of depressed mood and depression symptomatology was the predominant factor associated with how often our CRS patients missed work or school due to their CRS,” said senior author Ahmad R. Sedaghat, MD, PhD, a sinus surgeon at Massachusetts Eye and Ear and assistant professor of otolaryngology at Harvard Medical School. “The severity of even symptoms most typically related to CRS, such as nasal congestion, was not associated with how often our patients missed work or school due to their CRS.”

The researchers previously identified four categories of symptoms that dominate CRS—disturbances of sleep, nasal obstruction, ear and facial pain, and emotional function. In search of an association with lost productivity, the researchers assessed these four categories in 107 patients with CRS using a standardized survey. On average, study participants reported three missed days of work or school over a three-month period, or 12 missed days in a year.

When the researchers took a closer look at the surveys, they identified emotional symptoms, in which depression symptoms are the strongest feature, as the primary driver of missed days of work or school. The researchers were surprised to find that there was not an association between sleep disturbance or nasal obstruction symptoms—symptoms more commonly thought of in relation to CRS—with CRS patients missing days of work or school.

“In an effort to specifically tailor our CRS treatment to each patient, we have to be cognizant not just of the overall severity of the disease, but also of the severity of individual aspects, symptoms and manifestations of the disease,” Dr. Sedaghat said.